Background: Social determinants of health (SDOH) shape the conditions of a person’s daily life and include factors such as housing, occupation, education, safety and income. While physicians are aware of the inequalities that exists in healthcare, not all physicians feel adequately able to address such concerns. Understanding of factors that contribute to the development and perpetuation of inequities in health care must be developed at the medical education training level.
Objectives: Evaluate internal medicine residents’ understanding of SDOH and implement a curriculum on health disparities in order to improve their comfort in addressing social needs.
Methods: A survey regarding several aspects of SDOH were collected from the Rowan SOM/Jefferson Health NJ internal medicine residency program. A curriculum involving several didactic sessions was subsequently provided. A post-education survey was then administered to the same group to determine whether the curriculum had effectively addressed understanding of SDOH.
Results: Among 45 residents representing all three years of training, 72.4% did not fully understand factors composing SDOH. Interestingly, 100% of residents have cared for patients with social factors as the primary cause of inpatient admission, but 30% were not at all comfortable addressing SDOH. This dropped to 5.9% after implementation of the curriculum, indicating that 94.1% now feel comfortable and better equipped to address SDOH.
Conclusions: Very few residents understand SDOH, while most agree that social factors play a major role in health equity. Education should come at or before the residency level with the goal to not only educate, but to empower physicians to care for their patients with a more holistic approach
